Ramunni Alfonso, Petrarulo Francesco, Grasso Costanzo, Papagni Sergio, Brescia Paola
Section of Nephrology, Dept of Internal and Public Medicine, University of Bari, Bari, Italy.
Atheroscler Suppl. 2013 Jan;14(1):83-7. doi: 10.1016/j.atherosclerosissup.2012.10.018.
In most patients only a few sessions of apheresis treatment are necessary to see the benefit. This is the case of immunological diseases when the production of a pathologic component is limited in time or in microcirculation disturbances when changes of vascular function may occur. In the first instance the acute effect is likely due to the removal of the corresponding antibody, while in the second case the improvement of the endothelium-dependent vasodilation and the reduction of blood viscosity play a major role. In long-term treatment, as in the case of patients affected by familial hypercholesterolemia, the chronic effects of apheresis may lead to the repair of morphological alterations in the vascular wall. We report the recovery from ulcers in two hemodialysis patients suffering from peripheral arterial disease as the result of twenty-two sessions of rheopheresis. The reasons that justify these chronic actions may involve pleiotropic effects that are different according to the apheresis technique used.
在大多数患者中，仅需进行几次血液分离治疗就能看到效果。免疫性疾病就是这种情况，此时病理性成分的产生在时间上有限，或者在微循环障碍中，血管功能可能会发生变化。在第一种情况下，急性效应可能是由于相应抗体的清除，而在第二种情况下，内皮依赖性血管舒张的改善和血液粘度的降低起主要作用。在长期治疗中，如在家族性高胆固醇血症患者中，血液分离的慢性效应可能导致血管壁形态改变的修复。我们报告了两名患有外周动脉疾病的血液透析患者在进行了22次血液流变分离治疗后溃疡愈合的情况。证明这些慢性作用合理的原因可能涉及根据所使用的血液分离技术而不同的多效性效应。
